UTI Flashcards
types of UTI
acute pyelonephritis
chronic
cystitis
urethritis
prostatitis
epididymo-orchitis
risk factors
immunosuppression
steroids
malnutrition
diabetes
sexual intercourse
female sex
stasis
obstruction
causative organisms
E coli
klebsiella
enterococcus
proteus
TB
schistosomiasis
clinical features children
diarrhoea
excessive crying
failure to thrive
fever
nausea
clinical features adults
flank pain
strangury
dysuria
cloudy urine
urgency
chills
confusion in elderly
pyrexia
dehydration
investigations
mid stream urine sample
urinalysis- blood, leukocytes, protein, nitrites
if no leukocytes or nitrites UTI unlikely, if only leukocytes no nitrites dont treat as UTI yet
microscopy and gram stain
bacteruria > 10^5 CFU/ml
sensitivity to antibiotics
treatment
fluids
trimethoprim
cephalosporin
amoxicillin
IV if severe
3 days of antibiotics for a simple lower urinary tract infection in women
5-10 days of antibiotics for women that are immunosuppressed, have abnormal anatomy or impaired kidney function
7 days of antibiotics for men, pregnant women or catheter related UTIs
what shall you rule out in children
vesicoureteric reflux
pyelonephritis symptoms
Fever is a more prominent feature than lower urinary tract infections.
Loin, suprapubic or back pain. This may be bilateral or unilateral.
Looking and feeling generally unwell
Vomiting
Loss of appetite
Haematuria
Renal angle tenderness on examination
pylonephritis treatment
Referral to hospital if there are features of sepsis.
when treating pyelonephritis in the community:
one of
Cefalexin 14 days
Co-amoxiclav 7 days
Trimethoprim
Ciprofloxacin
causes of UTI
obstruction- vesicoureteric reflux, benign prostatic hyperplasia, uterine prolapse, tumours and calculi
loss of feeling of bladder
predisposition of infection
pushing bacteria up from below
catherisation
